{"title":"显微镜中心实施细针抽吸细胞学策略对诊断结核性淋巴结炎的影响","authors":"","doi":"10.1016/j.ijtb.2023.05.006","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><p><span><span><span>In India, EPTB accounts for about 50% of TB cases especially in people living with HIV/AIDS. Microbiological confirmation is present in only about 15% of EPTB cases. </span>Tuberculous Lymphadenitis is the most common form of EPTB in India, accounting for around 35% of EPTB cases. </span>Fine needle aspiration cytology<span> has been found to be highly sensitive and specific in the diagnosis of tuberculous lymphadenitis with 83–94% accuracy. The procedure of AFB detection is exactly the same for the FNAC obtained smears as for the presently examined </span></span>sputum smears at the DMCs. The aim of the present study was to determine the feasibility and effectiveness of FNAC strategy implemented at DMC level for detection of tuberculous lymphadenitis cases.</p></div><div><h3>Methods</h3><p>The present study was a randomized cluster trial with one control and one intervention arm. At the intervention units (DMCs) all suspected tuberculous lymphadenitis cases was subjected to FNAC of the suspected superficial lymph nodes by the trained Medical Officers. The control group was free from any such intervention. Effectiveness and feasibility of FNAC strategy in the intervention group was determined by relevant indicators.</p></div><div><h3>Results</h3><p>At the seven intervention DMCs, FNAC was performed on a total number of 1298 suspected cases of Tuberculous Lymphadenitis. Among them 294 cases were selected in the intervention arm and 196 cases in the control arm. Intervals between advice of FNAC and performance of FNAC as well as start of therapy was significantly low in the intervention arm. Complication was insignificant. The concordance between FNAC reports generated at the DMCs and that at Medical College estimated by agreement measurement kappa (0.970) suggested a high level of agreement.</p></div><div><h3>Conclusion</h3><p>Implementation of FNAC strategy at the DMC level for detection of tuberculous lymphadenitis cases was found to be feasible as well as effective.</p></div>","PeriodicalId":39346,"journal":{"name":"Indian Journal of Tuberculosis","volume":"71 3","pages":"Pages 269-275"},"PeriodicalIF":0.0000,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Impact of fine needle aspiration cytology strategy implemented at the microscopy center level for diagnosis of tuberculous lymphadenitis\",\"authors\":\"\",\"doi\":\"10.1016/j.ijtb.2023.05.006\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><p><span><span><span>In India, EPTB accounts for about 50% of TB cases especially in people living with HIV/AIDS. Microbiological confirmation is present in only about 15% of EPTB cases. </span>Tuberculous Lymphadenitis is the most common form of EPTB in India, accounting for around 35% of EPTB cases. </span>Fine needle aspiration cytology<span> has been found to be highly sensitive and specific in the diagnosis of tuberculous lymphadenitis with 83–94% accuracy. The procedure of AFB detection is exactly the same for the FNAC obtained smears as for the presently examined </span></span>sputum smears at the DMCs. The aim of the present study was to determine the feasibility and effectiveness of FNAC strategy implemented at DMC level for detection of tuberculous lymphadenitis cases.</p></div><div><h3>Methods</h3><p>The present study was a randomized cluster trial with one control and one intervention arm. At the intervention units (DMCs) all suspected tuberculous lymphadenitis cases was subjected to FNAC of the suspected superficial lymph nodes by the trained Medical Officers. The control group was free from any such intervention. Effectiveness and feasibility of FNAC strategy in the intervention group was determined by relevant indicators.</p></div><div><h3>Results</h3><p>At the seven intervention DMCs, FNAC was performed on a total number of 1298 suspected cases of Tuberculous Lymphadenitis. Among them 294 cases were selected in the intervention arm and 196 cases in the control arm. Intervals between advice of FNAC and performance of FNAC as well as start of therapy was significantly low in the intervention arm. Complication was insignificant. The concordance between FNAC reports generated at the DMCs and that at Medical College estimated by agreement measurement kappa (0.970) suggested a high level of agreement.</p></div><div><h3>Conclusion</h3><p>Implementation of FNAC strategy at the DMC level for detection of tuberculous lymphadenitis cases was found to be feasible as well as effective.</p></div>\",\"PeriodicalId\":39346,\"journal\":{\"name\":\"Indian Journal of Tuberculosis\",\"volume\":\"71 3\",\"pages\":\"Pages 269-275\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Indian Journal of Tuberculosis\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0019570723000926\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Indian Journal of Tuberculosis","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0019570723000926","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
Impact of fine needle aspiration cytology strategy implemented at the microscopy center level for diagnosis of tuberculous lymphadenitis
Introduction
In India, EPTB accounts for about 50% of TB cases especially in people living with HIV/AIDS. Microbiological confirmation is present in only about 15% of EPTB cases. Tuberculous Lymphadenitis is the most common form of EPTB in India, accounting for around 35% of EPTB cases. Fine needle aspiration cytology has been found to be highly sensitive and specific in the diagnosis of tuberculous lymphadenitis with 83–94% accuracy. The procedure of AFB detection is exactly the same for the FNAC obtained smears as for the presently examined sputum smears at the DMCs. The aim of the present study was to determine the feasibility and effectiveness of FNAC strategy implemented at DMC level for detection of tuberculous lymphadenitis cases.
Methods
The present study was a randomized cluster trial with one control and one intervention arm. At the intervention units (DMCs) all suspected tuberculous lymphadenitis cases was subjected to FNAC of the suspected superficial lymph nodes by the trained Medical Officers. The control group was free from any such intervention. Effectiveness and feasibility of FNAC strategy in the intervention group was determined by relevant indicators.
Results
At the seven intervention DMCs, FNAC was performed on a total number of 1298 suspected cases of Tuberculous Lymphadenitis. Among them 294 cases were selected in the intervention arm and 196 cases in the control arm. Intervals between advice of FNAC and performance of FNAC as well as start of therapy was significantly low in the intervention arm. Complication was insignificant. The concordance between FNAC reports generated at the DMCs and that at Medical College estimated by agreement measurement kappa (0.970) suggested a high level of agreement.
Conclusion
Implementation of FNAC strategy at the DMC level for detection of tuberculous lymphadenitis cases was found to be feasible as well as effective.
期刊介绍：
Indian Journal of Tuberculosis (IJTB) is an international peer-reviewed journal devoted to the specialty of tuberculosis and lung diseases and is published quarterly. IJTB publishes research on clinical, epidemiological, public health and social aspects of tuberculosis. The journal accepts original research articles, viewpoints, review articles, success stories, interesting case series and case reports on patients suffering from pulmonary, extra-pulmonary tuberculosis as well as other respiratory diseases, Radiology Forum, Short Communications, Book Reviews, abstracts, letters to the editor, editorials on topics of current interest etc. The articles published in IJTB are a key source of information on research in tuberculosis. The journal is indexed in Medline
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
